Abstract:
Purpose: Radical surgery is the preferred method for local high-risk and limited progressive prostate cancer in the routine clinical setting. However, current guidelines do not recommend neoadjuvant hormone therapy (NHT). Opinions regarding NHT vary among individual clinicians. According to the experience gained at our center, we explored the benefits of NHT for patients with prostate cancer during the perioperative period in this study. Methods: In this retrospective study, we explored the perioperative benefits of NHT among 189 patients with local high-risk or limited progressive prostate cancer who underwent radical prostatectomy and divided them into two groups: the NHT group and the non-NHT group. The NHT regimens were a gonadotropin-releasing hormone (GnRH) agonist alone (3.75/11.25 mg of leuprolide or 3.6/10.8 mg of goserelin acetate), an androgen receptor antagonist (ARA) alone, or a combination of the two. The duration of treatment was <3 months, 3 to 6 months, or >6 months. Results: We found that NHT could reduce the surgery time and intraoperative hemorrhage, thus reducing the difficulty of surgery; NHT could also improve the postoperative recovery of patients. However, it did not reduce the stage of prostate cancer or positive surgical margin rate. Conclusions: Neoadjuvant therapy is optional for some patients. We believe that NHT will improve the overall prognosis of patients as progress continues in the medical field in the future.
摘要:
目的:根治性手术是常规临床中局部高风险和局限性进展性前列腺癌的首选方法。然而,目前的指南不推荐新辅助激素治疗(NHT).关于NHT的意见因临床医生而异。根据我们中心的经验,在这项研究中,我们探讨了NHT对前列腺癌患者围手术期的益处.方法:在这项回顾性研究中,我们在189例接受根治性前列腺切除术的局部高危或局限性进展性前列腺癌患者中探讨了NHT的围手术期获益,并将其分为两组:NHT组和非NHT组.NHT方案是单独的促性腺激素释放激素(GnRH)激动剂(3.75/11.25mg亮丙瑞林或3.6/10.8mg醋酸戈舍瑞林),单独的雄激素受体拮抗剂(ARA),或两者的组合。治疗时间<3个月,3到6个月,或>6个月。结果:我们发现NHT可以减少手术时间和术中出血,从而降低手术难度;NHT还可以改善患者的术后恢复。然而,它没有降低前列腺癌的分期或阳性手术切缘率。结论:对于某些患者,新辅助治疗是可选的。我们相信,随着未来医疗领域的不断发展,NHT将改善患者的整体预后。